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Food Security & Nutrition around the World

Hunger is on the rise

For the third year in a row, there has been a rise in world hunger. The absolute number of
undernourished people, i.e. those facing chronic food deprivation, has increased to
nearly 821 million in 2017, from around 804 million in 2016. These are levels from
almost a decade
ago.

The number of hungry people is on the rise. 821 million people do not get enough food to eat.

The number of undernourished people in the world has been on the rise since 2014, reaching
an estimated 821 million in 2017

The share of undernourished people in the world population – the prevalence of
undernourishment, or PoU – may have reached 10.9 percent in 2017. Persistent instability in
conflict-ridden regions, adverse climate events in many regions of the world and economic
slowdowns that have affected more peaceful regions and worsened the food security, all help
to explain this deteriorating situation.

The situation is worsening in South America and most regions of Africa (Table 1).
Africa
remains the continent with the highest PoU, affecting almost 21 percent of the population
(more than 256 million people). The situation is also deteriorating in South America, where
the PoU has increased from 4.7 percent in 2014 to a projected 5.0 percent in 2017. Asia’s
decreasing trend in undernourishment seems to be slowing down significantly. The projected
PoU for Asia in 2017 is 11.4 percent, which represents more than 515 million people. Without
increased efforts, the world will fall far short of achieving the SDG target of eradicating
hunger by 2030.

Progress towards improving nutrition

Progress in child stunting and exclusive
breastfeeding but not in anaemia

Overall, there has been some progress regarding stunting and exclusive breastfeeding for the
first six months of life. The number of stunted children has decreased from 165.2 million
in
2012 to 150.8 million in 2017, a 9 percent decline. Yet, the number is still
unacceptably
high and the road to reaching the 2030 target is still long.

In 2017, 40.7 percent of infants below six months of age were exclusively breastfed, up from
36.9 percent in 2012. Rates of exclusive breastfeeding in Africa and Asia are 1.5 times
those in Northern America where only 26.4 percent of infants under six months receive
breastmilk exclusively.

Conversely, anaemia among women of reproductive age is not improving. The prevalence of
anaemia among women of reproductive age has risen incrementally from 30.3 percent in 2012 to
32.8 percent in 2016 with no region showing a decline. Shamefully, one in three women of
reproductive age globally is still affected by anaemia, with significant health and
development consequences for both women and their children.

Wasting

In 2017, 7.5 percent of children under five – 50.5 million – were affected by wasting (low
weight for height) consequently putting them at a higher risk of mortality. An analysis
from 2013 indicated that 875 000 deaths (or 12.6 percent of all deaths) among children under
five
years of age were related to wasting, of which 516 000 deaths (7.4 percent of all deaths
among under-fives) were related to severe wasting.

Child overweight and adult obesity

Since 2012, the global proportion of overweight children remains relatively stagnant,
with 5.4 percent in 2012 and 5.6 percent (or 38.3 million) in 2017. Of these 38.3 million
overweight children, 25 percent live in Africa and 46 percent live in Asia.

Adult obesity, on the other hand, is worsening. Adult obesity rates continue to rise each
year, from 11.7 percent in 2012 to 13.2 percent in 2016. This means that in 2017 more
than one in eight adults, or more than 672 million, in the world is obese.

The prevalence of obesity among adults in the world has been increasing steadily between 1975
and 2016 – and at an accelerated pace over the past decade. Adult obesity is highest in
Northern America and the rate of increase in adult obesity is also the highest there. While
Africa and Asia continue to have the lowest rates of obesity, an increasing trend can also
be observed.

The multiple burden of malnutrition

As mentioned before, levels of childhood stunting and wasting persist across regions and
countries; yet, simultaneously, there has been an increase in overweight and obesity, often
in the same countries and communities with relatively high levels of child stunting. This
coexistence of undernutrition with overweight and obesity is commonly referred to as the
“double burden” of malnutrition. A large proportion of the world population is also affected
by micronutrient (vitamin and mineral) deficiencies, often called “hidden hunger” because
there may be no visible signs. Iron deficiency anaemia in women of reproductive age is one
form of micronutrient deficiency.

A large proportion of the world population is also affected by micronutrient (vitamin and mineral)
deficiencies. This often called “hidden hunger” because there may be no visible signs.

Many countries have a high prevalence of more than one form of malnutrition. This multiple
burden of malnutrition is more prevalent in low-, lower-middle and middle-income countries
and concentrated among the poor. Obesity in high-income countries is similarly concentrated
among the poor. The coexistence of multiple forms of malnutrition can occur not only within
countries and communities, but also within households – and can even affect the same person
over their lifetime.

Pathways from food insecurity to malnutrition

Poor access to food and particularly healthy food contributes to undernutrition as well as
overweight and obesity. It increases the risk of low birthweight, childhood stunting and
anaemia in women of reproductive age, and it is linked to overweight in school-age girls and
obesity among women, particularly in upper-middle- and high-income countries. There are
several pathways from inadequate food access to multiple forms of malnutrition. Figure 14
illustrates two pathways: one leading from food insecurity to undernutrition and another
leading to overweight and obesity.

Pathways from inadequate food access to multiple forms of malnutrition

Food insecurity (unreliable access to food) can contribute to child wasting, stunting and
micronutrient deficiencies by negatively affecting the adequacy of food consumption. A diet
characterized by insufficient intake of calories, protein, vitamins and minerals will impede
foetal, infant and child growth and development. Such diets contribute to maternal
undernutrition and consequently to higher risk of low birthweight, which in turn are both
risk factors for child stunting. The stress of living with food insecurity can also have a
negative effect on the nutrition of infants by compromising breastfeeding.

Undernutrition and obesity coexist in many countries.

Although it may appear to be a paradox, food insecurity can also contribute to overweight and
obesity. Nutritious, fresh foods often tend to be expensive. Thus, when household resources
for food become scarce, people choose less expensive foods that are often high in calories
and low in nutrients. This is particularly true in urban settings and upper-middle and
high-income countries, although the negative effect of food insecurity on diet quality has
been documented in low-, middle- and high-income countries alike.

There are also psychosocial factors that link food insecurity to obesity. The experience of
not having certain or adequate access to food often causes feelings of anxiety, stress and
depression, which in turn can lead to behaviours that increase the risk of overweight and
obesity. These include patterns of binging or overeating when food is available (and
continued availability uncertain), or choosing low-cost, energy-dense “comfort foods” rich
in fat, sugar and salt. Such foods have been found to have physiological effects that reduce
stress in the short term.

Disordered eating patterns and food deprivation are another component linking food insecurity
to malnutrition. “Feast-and-famine” cycles cause metabolic changes that have been associated
with an increase in body fat, decrease in lean muscle mass, and more rapid weight gain when
food becomes plentiful.

In addition, maternal and infant/child food deprivation can result in foetal and early
childhood “metabolic imprinting”, which increases the risk of obesity and diet-related
on-communicable chronic diseases later in life. Maternal undernutrition – as well as
overweight– caused by lack of stable access to adequate diets can cause metabolic,
physiological and neuroendocrine changes in children, fueling intergenerational cycle of
malnutrition.

The coexistence of multiple forms of malnutrition means that the two pathways described above
do not work in isolation but rather impact each other. In this way, the undernutrition
linked with food security might at the same time be linked with overweight and obesity. As
described, food insecurity is associated with low birthweight in infants. Low birthweight is
a risk factor for child stunting, which in turn is associated with overweight and obesity
later in life. According to WHO, “Children who have suffered from undernutrition and were
born with low birthweight or are short for-age (stunted) are at far greater risk of
developing overweight and obesity when faced with energy-dense diets and a sedentary
lifestyle later in life.” It is also worth noting that children who are stunted have a
higher risk of being simultaneously overweight.

What can be done?

There is a need to implement and scale up interventions aimed at guaranteeing access to
nutritious foods and breaking the intergenerational cycle of malnutrition. The 1 000 days
between conception and a child’s second birthday is a window of unsurpassed opportunity to
both prevent child stunting and overweight and promote child nutrition, growth and
development with lasting effects over the child’s life. Exclusive breastfeeding in the first
six months and adequate complementary foods and feeding practices up to two years of age are
key to ensuring normal child growth and development during this crucial window of
opportunity.

Access to safe, nutritious and sufficient food must be framed as a human right, with priority
given to the most vulnerable. Policies must pay special attention to the food security and
nutrition of children under five, school-age children, adolescent girls and women in order
to halt the intergenerational cycle of malnutrition. A shift is needed towards
nutrition-sensitive agriculture and food systems that provide safe and high quality food,
promoting healthy diets for all.

Impact of Climate on Food Security & Nutrition

Last year SOFI pinpointed conflict and violence in several parts of the world as one of the
main drivers of hunger and food insecurity, suggesting that efforts to fight hunger must go
hand-in-hand with those to sustain peace. New evidence in this year’s report highlights
that beside conflicts, climate variability and extremes are also a key force behind the
recent rise in global hunger. They are also one of the leading causes of severe food
crises.

The number of extreme climate-related disasters, including extreme heat, droughts, floods and
storms, has doubled since the early 1990s.

The number of extreme climate-related disasters, including extreme heat, droughts, floods
and storms, has doubled since the early 1990s, with an average of 213 of these events
occurring every year during the period of 1990–2016. These harm agricultural productivity
contributing to shortfalls in food availability, with knock-on effects causing food price
hikes and income losses that reduce people’s access to food.

Increasing number of extreme climate-related disasters, 1990–2016

Total Events

Flood

Storm

Drought

Extreme temperature

Note: Total number of natural disasters that occurred in low- and middle-income countries by
region and during the period 1990–2016. Disasters are defined as medium and large scale
disasters that exceed the thresholds set for registration on the EM-DAT international
disaster database. See Annex 2, for the full definition of EM-DAT disasters.
Source: FAO elaboration based on data from Emergency Events Database (EM-DAT). 2009. EM-DAT
[online] Brussels. www.emdat.be

Climate variability and extremes are already negatively undermining production of major crops
in tropical regions and, without adaptation, this is expected to worsen as temperatures
increase and become more extreme.

In many areas, climate extremes have increased in number and intensity, particularly where
average temperatures are shifting upwards: very hot days are becoming more frequent and the
hottest days are becoming hotter. Extreme heat is associated with increased mortality, lower
labour capacity, lower crop yields and other consequences that undermine food security and
nutrition.

In addition to increasing temperatures and changes in rainfall, the nature of rainy seasons
is also changing, specifically the timing of seasonal climate events.

Within-season changes may not register as extreme climate events (droughts, floods or storms)
but rather are aspects of climate variability that affect the growth of crops and the
availability of pasture for livestock, with potentially significant implications for food
security and nutrition.

Several countries – notably in Africa, Central America and Southeast Asia – experienced
drought, not only through abnormally low total accumulated rainfall, but also through lower
rainfall intensities and fewer days of rainfall.

Drought’s direct connection to hunger

Food security and nutrition indicators can clearly be associated with an extreme climate
event, such as a severe drought, that critically challenges agriculture and food
production.

Of all natural hazards, floods, droughts and tropical storms affect food production the most.
Drought, in particular, causes more than 80 percent of the total damage and losses in
agriculture, especially for the livestock and crop production subsectors. In
relation to extreme events, the fisheries subsector is most affected by tsunamis and storms,
while most of the economic impact on forestry is caused by floods and storms. If a
drought is severe and widespread enough, it can potentially affect national food
availability and access, as well as nutrition, thus magnifying the prevalence of
undernourishment (PoU) nationally.

Hunger is significantly worse in countries with agricultural systems that are highly
sensitive to rainfall and temperature variability and severe drought, where the livelihood
of a high proportion of the population depends on agriculture and where the country does not
have in place sufficient support measures to counter the fallout. In other words, for almost
36 percent of the countries that experienced a rise in undernourishment since 2005, this
coincided with the occurrence of severe agricultural drought.

Out of 27 countries with increasing change points in the prevalence of undernourishment
occurring under severe drought stress conditions, most (19 countries) are in Africa, with
the remaining four in Asia, three in Latin America and the Caribbean, and one in Eastern
Europe.

A closer review reveals that many countries have witnessed periods of increased
undernourishment over the past years; however, during the period of the El Niño–Southern
Oscillation (ENSO) event of 2015–2016 this change across so many countries contributed to a
reversal of the PoU trend at the global level.

in focus

The case of El Nino

The temperature anomalies associated with El Niño show that climate variability and
extremes affect agriculture. If we look at increasing change points in the PoU time
series we see that many correspond to occurrences of severe drought. For example,
for almost 36 percent of the countries that experienced a rise in undernourishment
since 2005, this coincided with the occurrence of severe drought.

Most striking is the significant increase in the number of change points related to
severe drought conditions in 2014–2015 in which nearly two-thirds of the change
points occurred. In these cases,the PoU increased from 2015 onwards, and this can be
linked to severe droughts driven by El Niño in 2015–2016. A closer review reveals
that many countries have witnessed periods of increased undernourishment over the
past years; however, during the period of the ENSO event of 2015–2016 this change
across so many countries contributed to a reversal of the PoU trend at the global
level.

This association is further corroborated by a number of studies that show a strong
link between drought and stunting in children. For example, drought events in
Bangladesh are associated with a higher stunting rate around five and nine months
after the beginning of the drought event. In rural Zimbabwe, one- to two-year olds
exposed to drought face significantly lower growth velocity compared to children of
the same age living in areas with average rainfall. In sub-Saharan Africa, warmer
and drier climates are related to declining food availability and increased
prevalence estimates of childhood stunting

Climate variability and extremes are among the key drivers behind the rise in hunger.

Increased exposure to climate variability and
extremes

Exposure of countries to climate variability and extremes is also a rising trend. In 2017,
the average of the PoU in countries with high exposure to climate shocks was 3.2 percentage
points above that of countries with low or no exposure. Even more striking is that countries
with high exposure have more than doubled the number of undernourished people as those
without high exposure.

Higher prevalence and number of undernourished people in countries with high exposure to
climate extremes

Number of undernourished 2017 (millions)

Prevalence of undernourishment 2017

NOTES: Prevalence (unweighted) and number of undernourished people in low- and middle-income
countries with high and low exposure to climate extremes during the period of 2011–2016.
Countries with high exposure are defined as being exposed to climate extremes (heat,
drought, floods and storms) for more than 66 percent of the time, i.e. for more than three
years in the period 2011–2016; low exposure is three years or less. See Annex 2 for the list
of countries with high exposure to climate extremes and methodology. See Annex 2, for
the full definition of EM-DAT disasters.
SOURCE: C. Holleman, F. Rembold and O. Crespo (forthcoming). The impact of climate
variability and extremes on agriculture and food security: an analysis of the evidence and
case
studies. FAO Agricultural Development Economics Technical Study 4. Rome, FAO, for
classification of countries with high and low exposure to climate extremes; FAO for data on
prevalence
of undernourishment.

A high dependence on agriculture, as measured by the number of people employed in the sector,
leaves the PoU 9.6 percentage points higher (25 percent). For low-income countries, the
increase is equal to 13.6 percentage points (29 percent).

The finding is different for middle-income countries where the rise in PoU is less pronounced
and occurs later (from 2015–2016). This tends to indicate that middle-income countries were
able to absorb the impacts of increased exposure to climate extremes, but may not have been
able to cope as well in the 2015–2016 period, possibly due to the severity of exposure to El
Niño.

Other factors may have also come into play during this period, for example the economic
slowdowns that many Latin American countries experienced, which reduced the fiscal
environment to implement social programmes and thus diminished these countries’ capacity to
cope with the aftermath of extreme climate events.

Extreme events & food crises

While hunger is on the rise, it is equally alarming that the number of people facing
crisis-level food insecurity continues to increase.

In 2017, almost 124 million people across 51 countries and territories faced “crisis”
levels of acute food insecurity or worse, requiring immediate emergency action to safeguard
their lives and preserve their livelihoods. This represents an increase compared to 2015
and 2016, when 80 and 108 million people, respectively, faced crisis levels.

Climate related disasters account now for more than 80 percent of all major internationally
reported disasters.

In 34 of these 51 countries, more than 76 percent of the total populations facing crisis
levels of acute food insecurity or worse – nearly 95 million people – were also affected by
climate shocks and extremes. Where conflict and climate shocks occur together, the impact on
acute food insecurity is more severe. In 2017, 14 out of the 34 food-crisis countries
experienced the double impact of both conflict and climate shocks, which led to significant
increases in the severity of acute food insecurity.

Floods cause more climate-related disasters globally than any other extreme climate event,
with flood-related disasters seeing the highest increase – 65 percent – in occurrence over
the last 25 years. The frequency of storms is not increasing as much as that of floods, but
storms are the second most frequent driver of climate-related disasters.

Climate variability impact on all dimensions of Food
Security

The majority of people most vulnerable to climate shocks and natural hazards are the world’s
2.5 billion small-scale farmers, herders, fishers and forest-dependent communities, who
derive their food and income from renewable natural resources.

In 2015-2016, the drought caused by El Niño resulted in losses of 50-90 percent of the crop
harvest in the dry corridor, especially in El Salvador, Honduras and Guatemala.

Climate variability and extremes have the strongest direct impact on food
availability, given the sensitivity of agriculture to climate and the primary role of
the sector as a source of food and livelihoods for the rural poor. However, the overall
fallout is far more complex and greater than the impacts on agricultural productivity alone.

Climate variability and extremes are undermining all dimensions of food security: food
availability (with losses in productivity that undermine food production and increase food
imports); food access (causing spikes in food prices and volatility, especially following
climate extremes, income loss for those who depend on agriculture); food utilization and
food safety (worsened or reduced dietary consumption, reduced quality and safety of food
because of crop contamination, outbreaks of pests and diseases because of rainfall intensity
or changes in temperature.

Climate variability puts all aspects of food security at risk: the amount of food produced, people’s
access to it, people’s ability to absorb nutrients and the safety of the food itself.

Direct and indirect climate-driven impacts have a cumulative effect, leading to a downward
spiral of increased food insecurity and malnutrition.

As mentioned, an obvious impact is that climate variability and extremes negatively affect
agricultural productivity, in terms of changes in crop yields (the amount of
agricultural production harvested per unit of land area), cropping areas (area planted or
harvested), or cropping intensity (number of crops grown within a year).

Crop and livestock sub-sectors incur the highest damages and losses in agriculture due to
climate-related disasters, of which drought is the most destructive, 2006–2016

A) Damage and loss in agriculture as share of
total damage and loss across all sectors
by type of hazard

B) Damage and loss in agriculture by
agricultural sub-sector, percentage share of total

NOTES: FAO, based on Post Disaster Needs Assessments (PDNA), 2006–2016. The sectors of
fisheries, aquaculture and forestry often are under-reported. Impact of disasters on
forestry is generally acknowledged in assessments, although rarely quantified in monetary
terms. See Annex 2, for the full definition of EM-DAT disasters.
SOURCE: FAO. 2018. The impact of disasters and crises on agriculture and food security 2017.
Rome.

In addition, climate variability and extremes also affect food imports as countries
try to compensate for domestic production losses. The impacts on production will inevitably
translate into loss of income for people whose livelihoods depend on agriculture and natural
resources, reducing their ability to access food.

Another factor is spikes in food prices and volatility follow climate extremes.
Climate anomalies, and in particular extreme events, alter agricultural yields, production
and stocks. Episodes of high food price volatility pose a major threat to food access,
especially in low- and middle-income countries and among poorer groups in high-income
countries. The impact of price spikes and volatility not only falls heaviest on the urban
poor, but also of small-scale food producers, agriculture labourers and the rural poor who
are net food buyers.

Climate variability and extremes also lead to income loss for those whose livelihoods depend
on agriculture and natural resources, which then negatively impact food access as households
have less resources to purchase food. Household studies provide evidence that access to food
and income of small family agriculture households is negatively impacted by climate
variability and extremes. There is also evidence that climate shocks not only affect the
level of income, but affect also the variability of incomes.

The impact of price volatility falls heaviest on net food buyers, which are not only the
urban poor, but also small-scale food producers, agriculture labourers and the rural poor.

Changes in climate also heavily impact nutrition through impaired nutrient quality and
dietary diversity of foods produced and consumed; impacts on water and sanitation, with
their implications for patterns of health risks and disease; and changes in maternal and
child care and breastfeeding.

Households adopt coping strategies in response to food and income reductions and
increased prices following climate shocks. Coping strategies, including eating fewer meals
per day and less at each meal, skipping meals and eating less nutrient-dense foods and/or
more calorie-dense foods high in fat, sugars and salt, compromise dietary diversity and
quality.

More erratic rainfall and higher temperatures along with other extreme events affect the
quality and safety of food. Changing climate conditions and extremes such as
temperature and humidity can lead to increased contamination of water and food. Even
increased contamination of water used for irrigation can affect the safety of crops and
animals that consume them, as well as the resulting food output. Unsafe water and food
create a vicious cycle of diarrhoea and malnutrition, threatening the nutritional status of
the most vulnerable.

Studies have linked El Niño events with increased incidence of disease in human populations.
In East Africa, over half of El Niño occurrences have been accompanied by corresponding Rift
Valley Fever outbreaks.

Furthermore, climate extremes often directly affect human health through changes in
temperature and precipitation and natural hazards. These increase the risk of disease, which
further compromises food security and nutrition. Disease interferes with the body´s ability
to absorb nutrients, which can negatively affect the nutritional status of adults and
children.

Climate-related disasters create and sustain poverty, contributing to increased food
insecurity and malnutrition as well as current and future vulnerability to climate extremes.
They also have impacts on livelihoods and livelihoods assets – especially of the poor –
contributing to greater risk of food insecurity and malnutrition. Prolonged or recurrent
climate extremes lead to diminished coping capacity, loss of livelihoods, distress migration
and destitution.

Climate resilience is one solution. It is important to strengthen food systems and people’s
livelihoods to anticipate and adapt to the effects of climate variability and extremes.

Climate Resilience

Addressing climate variability and extremes and their impact on food security and nutrition
requires a focus on resilience. Context-specific interventions aimed at anticipating,
limiting, and adapting to the effects of climate variability and extremes and building the
resilience of livelihoods, food systems and nutrition to climatic shocks and stresses.

Scaled-up actions across sectors are urgently needed to strengthen the resilience of
livelihoods and food systems to climate variability and extremes. Such actions should take
place through integrated disaster risk reduction and management and climate change
adaptation policies, programmes and practices with short-, medium- and long-term vision